TY - JOUR
T1 - Esophageal Cancer After Bariatric Surgery: Increasing Prevalence and Treatment Strategies
AU - Plat, Victor D.
AU - Kasteleijn, Anne
AU - Greve, Jan Willem M.
AU - Luyer, Misha D. P.
AU - Gisbertz, Suzanne S.
AU - Demirkiran, Ahmet
AU - Daams, Freek
N1 - Funding Information: M.D.P. Luyer received research grants from Galvani and Medtronic. F. Daams received a research grant from Medtronic. The other authors have no conflicts of interest to report. Publisher Copyright: © 2021, The Author(s).
PY - 2021/11
Y1 - 2021/11
N2 - Purpose: The number of bariatric procedures has increased exponentially over the last 20 years. On the background of ever-increasing incidence of esophageal malignancies, the altered anatomy after bariatric surgery poses challenges in treatment of these cancers. In this study, an epidemiological estimate is presented for the future magnitude of this problem and treatment options are described in a retrospective multicenter cohort. Methods: The number of bariatric procedures, esophageal cancer incidence, and mortality rates of the general population were used for epidemiological estimates. A retrospective multicenter cohort was composed; patients were treated in three large oncological centers with a high upper gastrointestinal cancer caseload. Consecutive patients with preceding bariatric surgery who developed esophageal cancer between 2014 and 2019 were included. Results: Approximately 3200 out of 6.4 million post bariatric surgery patients are estimated to have developed esophageal cancer between 1998 and 2018 worldwide. In a multicenter cohort, 15 patients with esophageal cancer or Barrett’s esophagus and preceding bariatric surgery were identified. The majority of patients had a history of Roux-en-Y gastric bypass (46.7%) and had an adenocarcinoma of the distal esophagus (60%). Seven patients received curative surgical treatment, five of whom are still alive at last follow-up (median follow-up 2 years, no loss to follow-up). Conclusion: Based on worldwide data, esophageal cancer development following bariatric surgery has increased over the past decades. Treatment of patients with esophageal cancer after bariatric surgery is challenging and requires a highly individualized approach in which optimal treatment and anatomical limitations are carefully balanced. Graphical abstract: [Figure not available: see fulltext.]
AB - Purpose: The number of bariatric procedures has increased exponentially over the last 20 years. On the background of ever-increasing incidence of esophageal malignancies, the altered anatomy after bariatric surgery poses challenges in treatment of these cancers. In this study, an epidemiological estimate is presented for the future magnitude of this problem and treatment options are described in a retrospective multicenter cohort. Methods: The number of bariatric procedures, esophageal cancer incidence, and mortality rates of the general population were used for epidemiological estimates. A retrospective multicenter cohort was composed; patients were treated in three large oncological centers with a high upper gastrointestinal cancer caseload. Consecutive patients with preceding bariatric surgery who developed esophageal cancer between 2014 and 2019 were included. Results: Approximately 3200 out of 6.4 million post bariatric surgery patients are estimated to have developed esophageal cancer between 1998 and 2018 worldwide. In a multicenter cohort, 15 patients with esophageal cancer or Barrett’s esophagus and preceding bariatric surgery were identified. The majority of patients had a history of Roux-en-Y gastric bypass (46.7%) and had an adenocarcinoma of the distal esophagus (60%). Seven patients received curative surgical treatment, five of whom are still alive at last follow-up (median follow-up 2 years, no loss to follow-up). Conclusion: Based on worldwide data, esophageal cancer development following bariatric surgery has increased over the past decades. Treatment of patients with esophageal cancer after bariatric surgery is challenging and requires a highly individualized approach in which optimal treatment and anatomical limitations are carefully balanced. Graphical abstract: [Figure not available: see fulltext.]
KW - Bariatric surgery
KW - Esophageal cancer
KW - Esophagectomy
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85114375643&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85114375643&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/34494230
U2 - https://doi.org/10.1007/s11695-021-05679-1
DO - https://doi.org/10.1007/s11695-021-05679-1
M3 - Article
C2 - 34494230
SN - 0960-8923
VL - 31
SP - 4954
EP - 4962
JO - Obesity Surgery
JF - Obesity Surgery
IS - 11
ER -